Disparities identified in treatment of chlamydia and gonorrhea in primary care

Background and goal: Prompt treatment of chlamydia and gonorrhea following a confirmed diagnosis is essential to prevent complications and reduce transmission. Adherence to the Centers for Disease Control (CDC) treatment guidelines in primary care settings remains a concern. This study aimed to quantify the overall treatment rate for chlamydia and gonorrhea and identify factors associated with treatment delays and disparities. 

Study approach: Researchers analyzed electronic health record data from the PRIME registry, which includes information from over 2,000 primary care clinicians across the United States. The study included patients diagnosed with chlamydia or gonorrhea between 2018 and 2022 and assessed whether they received appropriate antibiotic treatment within 30 days of diagnosis.

Main results: 6,678 cases of chlamydia and 2,206 cases of gonorrhea confirmed by a positive test were identified.

• 75.3% of chlamydia cases and 69.6% of gonorrhea cases were treated within 30 days.

• More than 80% of treated patients received antibiotics within 7 days of diagnosis.

• Only 14% of chlamydia cases were treated with the recommended doxycycline and only 38.7% of gonorrhea cases were treated with the recommended ceftriaxone.

• Women, young adults (ages 10-29), and suburban residents were more likely to receive treatment.

• Time to treatment of chlamydia was longer for patients aged 50-59 years and for non-Hispanic Black patients.

Why it matters: Many patients with chlamydia and gonorrhea in primary care settings do not receive the recommended treatment. This gap in care may contribute to ongoing STI transmission and adverse health outcomes, particularly among marginalized populations.